The mechanical properties of the heart are well understood. Tricuspid valve calcification may lead to stenosis, resulting in myocardial hypertrophy and decreased cardiac output. On the other end of the spectrum, mitral valve prolapse may lead to eventual mitral regurgitation. Eventually, chronic tendinous injury to the chordae tendineae attaching the valve to the papillary muscles may occur, producing a flail leaflet. It is simple: the heart strings produce the music of harmony.
But what of discord? What of when the harmony fails us?
As clinicians and clinicians-in-training, we are often most concerned with the body’s physical ailments, with that which we may touch and, through the will of materialism, treat. When we focus solely on these tangible matters, however, we do ourselves and our potential patients a disservice. Beyond the empirical, there is the emotional and spiritual that requires counsel and nurturing. It is unavoidable in a profession which promises to have us face time and time again the reality of death – that of our patients, and the grief of their loved ones.
What is the would-be physician to do? It matters not your individual religious inclination or lack thereof: you must guide and comfort. In her lovingly rendered work “In This Chamber Most Sacred,” Nancy Young gestures toward this idea in depicting an open thoracic cavity. Expecting the throbbing atria and ventricles, the viewer is instead confronted with endless arches most emblematic of the architecture seen in abbey churches. The interpretation is difficult to evade: how does the physician heal the trauma to the spirit, once the trauma to the body is resolved?
In writing “Heart Transplant,” I had hoped to touch upon similar sentiments in contrasting the nonchalance of an impersonal transplanting cardiothoracic surgeon
you may be laid upon a table
& cautiously split
down crackling bone?
with the hesitancy and fear of an uncertain patient
if you cut out a heart, this heart
( me : your heart )
will there be
While the identity of the “heart” is left open so that the experiences of the reader may reflect and fill the void, the implication of the work is less fluid and opaque: those who undergo intensive, life-altering surgery require therapy to rehabilitate them not only from the physical trauma of violent change, but from the emotional and spiritual as well. It isn’t enough for the physician to simply reattach the heart strings: the strings need to play a dulcet melody after, too.
Schneider K. Rancy is a Haitian-American graduate of Columbia University, where he studied English and Comparative Literature, and Biology. His poetry has been featured in Columbia New Poetry magazine, which publishes experimental works of poetry and art. He is also a matriculating medical student in New York City. His peer-reviewed research articles on nerve and wrist reconstruction have been published in the Journal of Hand Surgery (American Volume), the Journal of Hand Surgery (European Volume), and the Journal of Wrist Surgery. His poem “Heart Transplant,” appears in the Spring 2017 Intima.